Medicare MBI and Medicare Eligibility Response Changes

CMS sent out the notice below last week in MLN. they have still not decided to allow vendors like Change Healthcare, Availity, or Experian Health to access this tool. If a Medicare beneficiary presents without their new card and they’re in one of the states that has received their cards, you will have to log onto the MACs site to find the new number.

New Medicare Card: MBI Look-up Tool Available through your MAC

All Medicare Administrative Contractor (MAC) secure portal Medicare Beneficiary Identifier (MBI) look-up tools are ready for use. If you don’t already have access, sign up for your MAC’s portal to use the tool.

Live in Alaska, American Samoa, California, Delaware, District of Columbia, Guam, Hawaii, Maryland, Northern Mariana Islands, Oregon, Pennsylvania, Virginia, and West Virginia

Get Railroad Retirement Board benefits

Are newly entitled to Medicare

Medicare Eligibility Response Changes June 2018

CMS will be making the following changes their eligibility response this month.

CMS will start allowing service type code CQ to be requested. CQ (Case Management) should be sent when requesting eligibility information on the Medicare Diabetes Prevention Program.

Responses for providers that are identified as an MDPP provider will change. If an eligibility response is received for a provider that has a D1 specialty code in their NPI file, the response will only return the following: